Pectoralis major tendon tears, or pec tears, have become more common over the years. This is most likely attributed to increased participation in collision sports, such as boxing, hockey, football, and weightlifting. This form of injury happens most commonly in males between the age of 20 and 40. As we are well into football season, it’s important to be well aware of the causes, diagnosis, and treatment of this prevalent condition.
Anatomy:
The pectoralis major is comprised of three distinct divisions: the clavicular head, the sternocostal head, and the abdominal head. The two most common injuries involve an isolated sternocostal head (in my series most often the result of the bench press in the final phase of eccentric contraction as the athlete transitions to a concentric contraction) or a complete tear (often as a result of an injury while playing a collision sport, such as an outside linebacker tackling an opponent).
Diagnostic Tests:
The pec tear may involve one or more of these components and is best assessed with an MRI specifically focused on evaluating the Pectoralis Major rather than the Shoulder.
Treatment:
The injured athlete should seek treatment from an orthopaedic surgeon who has a specific focus and experience with pectoralis major tendon repair. Operative treatment is the conservative treatment for most tears, especially those in young, active patients as it provides the only reliable restoration of function and strength.
At Hospital for Special Surgery, we have a history of treating athletes ranging from the youth level through professional. If you suspect that you may be dealing with this form of injury, it is important to consult with a physician immediately. We have reported and published our surgical repair results in a large group of collegiate and professional athletes demonstrating greater than 96% patient satisfaction, with excellent restoration of function and adduction strength in 85-90% allowing for a return to unrestricted athletic activities at an average of 5.5 months.
Dr. Frank Cordasco is an Orthopedic Surgeon in the Sports Medicine and Shoulder Service at Hospital for Special Surgery. The primary focus of Dr. Cordasco’s practice includes ACL and meniscus injury in the pediatric, adolescent, and adult athlete; shoulder instability; bicep tendon tears, rotator cuff and pectoralis tendon repairs, clavicle fracture surgery and AC joint separations. Dr. Cordasco’s research and education activities parallel and complement these clinical areas of expertise.
